Perfil de sensibilidade do gênero Candida a antifúngicos em um hospital de referência da Região Norte do Brasil

Emmanuel Borges Nunes; Natália Borges Nunes; Julius Caesar Mendes Soares Monteiro; Andrea Luzia Vaz Paes

doi:10.5123/S2176-62232011000400004

Authors

Emmanuel Borges Nunes Hospital Universitário João de Barros Barreto, Belém, Pará, Brasil
Natália Borges Nunes Universidade Federal do Pará, Belém, Pará, Brasil
Julius Caesar Mendes Soares Monteiro Universidade Federal do Pará, Belém, Pará, Brasil
Andrea Luzia Vaz Paes Universidade do Estado do Pará, Belém, Pará, Brasil; Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Pará, Brasil

DOI:

https://doi.org/10.5123/S2176-62232011000400004

Keywords:

Candida, Antifungal Agents, Drug Resistance

Abstract

ABSTRACT

INTRODUCTION: An increased number of antifungal-resistant Candida infections have been observed in the last few years, primarily in hospital environments. This resistance has increased the failure rate for treating these infections and, consequently, caused greater morbidity and mortality.
OBJECTIVE: To determine the antifungal sensitivity profile of species from the Candida genus in a reference hospital.
MATERIAL AND METHODS: A cross-sectional study was performed in a university hospital that is part of the public hospital network in the City of Belém, Para State, Brazil, between July 2008 and June 2010. Isolates were selected from Candida spp that grew in fungal cultures of clinical specimens. The species were identified using the automated Mini API^® system from bioMérieux^®, and their sensitivity was tested using the ATB^® Fungus 2 bioMérieux^® system following the Clinical and Laboratory Standards Institute (NCCLS/CLSI; M27-A2) interpretation protocol. The data were gathered into tables and then were subjected to descriptive and inferential statistical analyses.
RESULTS: All 81 Candida isolates were sensitive to amphotericin B and flucytosine, while 3.7% and 4.9% were resistant to fluconazole and voriconazole, respectively. Additionally, 16% of the Candida spp isolates were resistant to itraconazole. None of the C. albicans isolates were resistant to itraconazole, while three (9%) were sensitive in a dose-dependent manner. The C. tropicalis isolates were resistant to at least one of the tested antifungals (42.9%), while only 23.8% were sensitive to itraconazole.
CONCLUSION: The high resistance rates for C. tropicalis and Candida spp to itraconazole indicate that there are risk factors, and these rates support the adoption of measures to avoid the indiscriminant use of antifungals in the epidemiological surveillance of nosocomial candidemia.